Sagging lower face. Dermal fillers/or hifu? (photo)

Question

I have mild sagging on my lower face, i've lost some facefat before especially on my mid face area, in this case is it better for me to treat that sagged lower jowls by hifu or dermal fillers. Do i need dermal fillers or just hifu is ok for sagging jowls or it can make my face worse according to the picture i shared. Also with the dermal fillers i am afraid for unnatural look. Thank you.

Jonghyun Hong, MD · Answer

Hello,
This is Dr. Hong from Seoul, Korea. I’d like to explain the common causes of jowls and offer some treatment options.
Jowls typically appear due to:
Decreased skin elasticityLoosening of facial muscles and subtle bone structure changes that occur with agingExcess fat accumulation in the jaw and cheek areasHIFU (High-Intensity Focused Ultrasound) can provide temporary improvement for jowls. Ex) Ulthera can also be effective, but in my experience, the results can vary significantly from patient to patient. Some are highly satisfied, while others see minimal improvement.There is other treatments may offer more lasting results:1) Morpheus-8 RF microneedling can improve skin elasticity and help reduce excess fat in the area.
2) Thermage is a safe option for improving skin elasticity, as it specifically targets the skin.I don’t recommend fillers for jowls, as they can sometimes make the face appear bulkier and worsen sagging over time, potentially compromising skin elasticity.
For more lasting results, I suggest considering a thread lift combined with mini liposuction (if excess fat is present). This approach will provide a longer-lasting outcome, helping you maintain a youthful appearance with regular skincare.
I hope this information helps guide you in making the best decision for your treatment.
Warm regards,Dr. Hong

Anna Chacon, MD, FAAD · Answer

Dermal Fillers
Dermal fillers, particularly those based on hyaluronic acid like Restylane Lyft and Juvederm, can be effective in lifting and contouring the lower face. They work by restoring volume to the mid-face and jawline, which can indirectly soften the appearance of jowls.

A combination approach of mid-face and lower-face filler injections can provide significant improvement in the contour of the jawline and reduce the appearance of jowl.

HIFU (High-Intensity Focused Ultrasound)
HIFU can also be used to tighten the skin and improve the appearance of sagging jowls by stimulating collagen production. However, it may not be as immediately effective as dermal fillers for severe sagging and may require multiple sessions.

Combined Approach
A combined approach using both dermal fillers and HIFU can be considered for optimal results. Fillers can provide immediate volume and lift, while HIFU can offer long-term skin tightening benefits.

In summary, dermal fillers are often recommended for immediate and noticeable results, while HIFU can be used for a more gradual and long-term tightening effect. A consultation with a professional is advisable to determine the best treatment plan based on individual needs.

Camille Cash, MD · Answer

You will likely have a more complete result from a combination of treatments.  You can begin with Morpheus8.  This treatment combines RF technology with microneedling to improve overall skin tone and texture. Dermal fillers can be added to define contours.  I've included a video I hope you find helpful.

Stefan Weiss, MD · Answer

Dermal fillers, if administered correctly, can do a great job restoring balance to the chin area with it.

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